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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Olecranon Fractures: Patterns, Fixation Types, and Outcomes.

Kashif Memon1, Raghunaathan Rangan1, Musab Mohamed1

  • 1Trauma and Orthopedics, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.

Cureus
|May 5, 2026
PubMed
Summary

Prominent metalwork after olecranon fracture fixation is common, often requiring removal. Tension band wiring (TBW) and plate fixation show similar rates of symptomatic hardware, with plating having a slightly lower removal incidence.

Keywords:
hardware irritationolecranon fractureorthopedic traumaplate fixationprominent metalworksuture fixationtension band wiring

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Area of Science:

  • Orthopedic surgery
  • Trauma surgery
  • Biomaterials engineering

Background:

  • Prominent metalwork is a frequent cause of discomfort after olecranon fracture fixation.
  • This often leads to elective implant removal, even with successful bone healing.

Purpose of the Study:

  • To assess the incidence and pattern of symptomatic hardware prominence.
  • To compare different fixation methods: tension band wiring (TBW), plate fixation, and suture constructs.

Main Methods:

  • Retrospective review of adult patients with olecranon fractures (Jan 2021 - Jul 2025).
  • Included patients with ≥12 weeks follow-up, analyzing open and closed fractures.
  • Compared TBW, pre-contoured/hook plate fixation, and high-strength suture constructs; primary outcome was reoperation rate.

Main Results:

  • 62 patients (mean age 57) with mean 46-week follow-up were analyzed.
  • 15/62 patients had prominent metalwork, leading to 11 implant removals (3 TBW, 8 plating).
  • Symptomatic metalwork rates were 27% (TBW) vs. 26% (plating); removal rates were 27% (TBW) vs. 17% (plating).

Conclusions:

  • Both TBW and plate fixation offer stable olecranon fracture fixation and union.
  • Prominent metalwork is a significant issue, driving secondary surgeries.
  • Careful implant choice, soft-tissue management, and patient counseling are crucial for optimal outcomes.